Teens Research Paper Sample

Iron Deficient Anemia

Iron Deficient Anemia

Background

Iron deficiency anemia is a decease caused by lack of iron in the organism due to balance failure between iron income, intake and loss. It is the most common type of anemia, as 80% of the anemia cases are attributed to iron deficiency (Bunn & Aster, 2011). Although the iron deficient anemia rarely causes death, its impact on human health is significant.
Despite of the fact that iron is a widespread element, iron deficiency is common for humans. Iron is a micronutrient constituent of the erythrocytes respiratory pigment, hemoglobin. Accordingly, the main cause of iron deficiency anemia is hemorrhage, or chronic hemorrhage; in most cases, metrorrhagia. Moreover, anemia can be caused by inadequate iron intake, high usage of iron during growth, maturation of the organism during pregnancy and lactation. The other reasons are decrease of iron absorption during the diseases of gastrointestinal tract, and failure of the iron transport (Stang & Story, 2005).
Pathogenesis of iron deficiency anemia is the following: lack of iron caused by endogenic and xenogeneic etiological factors leads to failure of the hem production (iron is a constituent of hem). Hem is a hemoglobin component. This causes the hemoglobin level reduction and the blood oxygen-transport decrease with development of hemic hypoxia, which is reduction of tissues oxygen supply below physiological levels (World Health Organization, 2001).

Objective

Large number of people of various races, ages and social status are under risk of anemia. Table 1 describes the main causes of anemia.
Two categories of people with the highest risk of anemia will be described, namely pregnant women and children (infants, young children and teens).

Infants and children

In most cases, iron deficiency anemia is diagnosed with children after 6 months. During the first six month, breastfeeding provides the sufficient quantities of iron. Then, the other iron sources have to be included in the diet. Although children may not reveal preferences for iron-fortified food, the diet must include iron-reach products, namely eggs, cereal, meat, and green vegetables. In case of iron deficiency, the risk of anemia increases (World Health Organization, 2001).
Yamamoto, Inaba, Okamoto, Patrinos & Yamashroya (2004) presented the distinctive case of iron deficiency anemia with an infant. A toddler boy of 22 month old was presented to the clinic with pallor complaints. The pallor was identified by a relative who did not see the boy for some time. However, the mother did not indicate any specific changes since the child is fair skinned. After review, the toddler appears active and does not show fatigue, sleeping increase and or exercise intolerance. No signs of stool disorder were diagnosed (blood, black or tarry stool). The child prefers milk to other food (drinks 6-8 bottles per day), and also eats some vegetables, small quantities of chicken and pork. One distant relative was diagnosed with anemia during pregnancy, and this is the only case in the family. There were no cases of splenectomy or gallstones.
The blood analysis revealed the following complete blood count (Table 2) and reports microcytosis, hypochromia, mild anisocytosis and polychromasia, no basophilic stippling was diagnosed.
The patient was diagnosed with iron deficiency anemia. Oral iron is prescribed, and milk intake limit recommended. After 3 days, red cell distribution width and reticulocyte count improved to 27 and 12%, respectively. The two-week therapy results in hemoglobin level of 8.5 g/dl, two-month therapy increased the hemoglobin level to normal state. The iron intake was recommended for three more month.

Teen years is the most intensive period of human development. Therefore, the organism requires high iron intake for growth and development. The special risk group are teenage girls with heavy menstrual periods.

Pregnant women

Iron deficiency anemia is common among pregnant women, since the state requires double iron amount: for a woman and for the fetus growth. Thus, almost 50% of pregnant suffer from iron deficiency anemia (World Health Organization, 2001).
Layola University Medical Education Network (2014) presented a clinical case of 35-year-old women at 24th week of pregnancy (third child in three years). She had been reported fatigue for the extended period, without other complaints. There was no history of anemia in the family, neither drinking nor smoking habits; no fortified food or vitamins were taken. Physical examination disclosed pale conjunctiva, mild nail spooning, systolic murmur at left lower sternal border. Blood test results are presented in Table 2. Stools were found negative for occult blood. The strange wish for eating ice had been noticed recently. The woman was diagnosed with anemia.

Results

The targeted populations have the same mechanism of iron deficiency, namely lack of alimentary iron due to increased need of iron.

There are various mechanisms for preventing the iron deficiency anemia, depending on the group.

For children, doctors usually recommend limitation of cow milk to babies for the first year. Cow milk is low in iron. A child drinking sufficient quantity of milk may not be eating other types of iron-rich food.
Babies need more iron for growth as they begin to eat solid food. The recommendations for iron-intake increase are presented below.
- Breastfed or partially breastfed infants under 12 month can be given iron-fortified infant formula with 4–12 mg of iron.
- Babies older than 4 months can be given iron-rich or iron-fortified solid food (e.g. cereal).
Pregnant women need to intake a double dose of iron-fortified products to prevent the development of disease. In addition, the doctors providing prenatal care may prescribe iron supplements (World Health Organization, 2001).

Iron Deficiency Treatment

For treatment of iron deficiency anemia, doctors typically recommend a diet rich in iron, folic acid, and vitamin C. Iron from meats is readily absorbed by the body than iron from vegetables and other food. However, iron overdose is harmful; therefore, the dosage should be carefully followed. The overload of iron causes the hemochromatosis – storage of the excess quantities of iron in liver, heart, or pancreas and poisoning leading to life-threatening conditions (cancer, heart arrhythmias and cirrhosis).
If fast increase of iron level is required, a doctor can prescribe iron supplements. In a complex treatment of iron deficiency anemia the Vitamin C supports iron absorption.

The section below describes dietary recommendations for people suffering from iron deficiency anemia (Corleone, 2011).

Breakfast. A high-iron breakfast may include 1 cup of iron-fortified instant oatmeal with dried raisins, served with fresh orange juice. This type of meal supplies about 13 mg of iron, and vitamin C in the orange juice helps to improve iron absorption. Coffee and tea can inhibit iron absorption, therefore on anemia diet, tea and coffee is recommended between meals (Corleone, 2011).
Lunch. For lunch, a roast beef sandwich with lean beef meat on iron-enriched bread should be taken. A vegetable addition includes 1 cup of sliced strawberries, carrot sticks served with low-fat yogurt. The meal contains about 5 mg of iron. It should be taken into account that whole grains decrease iron absorption and thus refined-flour products (white bread) are better be excluded on high-iron diet (Corleone, 2011).
Dinner. For dinner, the nutritionist may recommend roasted chicken breast (3 oz.) served with a medium baked potato and margarine (1 tsp.), cooked lima beans (1 cup) and steamed broccoli. This would supply about 5.6 mg of iron, and some amount of vitamin C in the baked potato and broccoli will help increase your iron absorption (Corleone, 2011).
The successful treatment is also about avoiding some products that interfere with iron absorption or cause iron depletion. These are coffee and tea, bran, egg whites, white bread, sugar and sweet desserts.

Conclusions

Iron deficiency anemia is a widespread disease. There are numerous reasons of anemia: chronic hemorrhage, alimentary lack of the iron, the increased iron need. The paper describes anemia caused by the increased need in iron. Children and pregnant women are target group for the decease. The alimentary reason is the most common for iron deficiency. The main preventive method is iron-reach diet. Decease can be prevented by intake of iron-fortified food. However, the doctor’s instructions should be followed since the excessive amount of iron is harmful.
In case iron deficiency anemia developed as a result of disease, patients need a special treatment, similar to preventive therapy, namely intake of the iron supplements and iron-fortified food.
Nowadays, iron deficiency anemia is not a fatal disease, because the treatment strategies are known and they are relatively simple to realize. However, people under risk of anemia should follow preventive measures.

References

Centers for Disease Control and Prevention. (2014). Iron and iron deficiency. Centers for Disease control and prevention. Retrieved from http://www.cdc.gov/nutrition/everyone/basics/vitamins/iron.html.
Corleone, J. (2011). Daily Meal Plan for People With Anemia. Livestrong. Retrieved from http://www.livestrong.com/article/364683-daily-meal-plan-for-people-with-anemia.
Bunn, H. F. & Aster, J. C. (2011). Pathophysiology of blood disorders. New York: McGraw-Hill Medical.
Layola University Medical Education Network (2014). Patient with Anemia. Retrieved from http://www.meddean.luc.edu/lumen/meded/mech/cases/case7/case_f.htm.
Stang J. & Story M. (Eds.) (2005). Guidelines for Adolescent Nutrition Services. Retrieved from http://www.epi.umn.edu/let/pubs/img/adol_ch9.pdf.
World Health Organization (2001). Iron deficiency anaemia assessment, prevention and control. A guide for programme managers. Retrieved from http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf.
Yamamoto, L. G., Inaba, A. S., Okamoto, J. K., Patrinos, M. E. & Yamashroya, V. K. (Eds) (2004). Case based pediatrics for medical students and residents. Retrieved from http://www.hawaii.edu/medicine/pediatrics/pedtext/pedtext5.pdf.